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Association Between the PRIMARY Score at Staging Prostate-specific Membrane Antigen Positron Emission Tomography and Overall Survival Among Patients with Newly Diagnosed Prostate Cancer : Findings from the International, Multicenter PROMISE Registry

Karpinski, Madeleine J. ; Hoberück, Sebastian ; Fendler, Wolfgang P. ; Civan, Caner ; Bundschuh, Ralph A. ; Thomas, Christian ; Bjartell, Anders LU ; Trägårdh, Elin LU orcid ; Soeterik, Timo F.W. and Evangelista, Laura , et al. (2026) In European Urology 89(2). p.123-127
Abstract

The PRIMARY score was implemented in Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) version 2 to improve accuracy for the diagnosis of clinically significant prostate cancer using prostate-specific membrane antigen (PSMA) positron emission tomography (PET). We reviewed overall survival (OS) for patients who underwent PSMA PET for initial staging to evaluate the prognostic value of PRIMARY in a large, international, multicenter cohort. The cohort comprised 1889 patients who underwent PSMA PET for initial staging of prostate cancer at investigator sites across Europe and Australia between 2012 and 2021. Hazard ratios (HRs) with 95% confidence interval (CI) were calculated for PRIMARY scores to identify predictors of... (More)

The PRIMARY score was implemented in Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) version 2 to improve accuracy for the diagnosis of clinically significant prostate cancer using prostate-specific membrane antigen (PSMA) positron emission tomography (PET). We reviewed overall survival (OS) for patients who underwent PSMA PET for initial staging to evaluate the prognostic value of PRIMARY in a large, international, multicenter cohort. The cohort comprised 1889 patients who underwent PSMA PET for initial staging of prostate cancer at investigator sites across Europe and Australia between 2012 and 2021. Hazard ratios (HRs) with 95% confidence interval (CI) were calculated for PRIMARY scores to identify predictors of OS. Complete-case head-to-head comparisons were conducted for Prostate Imaging-Reporting and Data System (PI-RADS) versus PRIMARY scores, and cT stage versus PRIMARY scores. We present preliminary findings up to January 31, 2025, when 231 deaths had occurred. PRIMARY score 5 (HR 1.5, 95% CI 1.0–2.3; p = 0.045) was associated with shorter OS. Improvements in C index values confirmed the added prognostic value of the PRIMARY score when combined with PI-RADS or cT stage. PRIMARY score 5 on initial PSMA PET is prognostic for shorter OS. There is ongoing long-term follow-up in the PROMISE registry (NCT06320223, promise-pet.org).

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Overall survival, Positron emission tomography, PRIMARY score, Prostate cancer, Prostate-specific membrane antigen
in
European Urology
volume
89
issue
2
pages
5 pages
publisher
Elsevier
external identifiers
  • pmid:41168067
  • scopus:105024956031
ISSN
0302-2838
DOI
10.1016/j.eururo.2025.10.013
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s).
id
37db5238-ac01-475a-8082-c9dff31c0107
date added to LUP
2026-03-03 14:11:11
date last changed
2026-05-13 01:53:09
@article{37db5238-ac01-475a-8082-c9dff31c0107,
  abstract     = {{<p>The PRIMARY score was implemented in Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) version 2 to improve accuracy for the diagnosis of clinically significant prostate cancer using prostate-specific membrane antigen (PSMA) positron emission tomography (PET). We reviewed overall survival (OS) for patients who underwent PSMA PET for initial staging to evaluate the prognostic value of PRIMARY in a large, international, multicenter cohort. The cohort comprised 1889 patients who underwent PSMA PET for initial staging of prostate cancer at investigator sites across Europe and Australia between 2012 and 2021. Hazard ratios (HRs) with 95% confidence interval (CI) were calculated for PRIMARY scores to identify predictors of OS. Complete-case head-to-head comparisons were conducted for Prostate Imaging-Reporting and Data System (PI-RADS) versus PRIMARY scores, and cT stage versus PRIMARY scores. We present preliminary findings up to January 31, 2025, when 231 deaths had occurred. PRIMARY score 5 (HR 1.5, 95% CI 1.0–2.3; p = 0.045) was associated with shorter OS. Improvements in C index values confirmed the added prognostic value of the PRIMARY score when combined with PI-RADS or cT stage. PRIMARY score 5 on initial PSMA PET is prognostic for shorter OS. There is ongoing long-term follow-up in the PROMISE registry (NCT06320223, promise-pet.org).</p>}},
  author       = {{Karpinski, Madeleine J. and Hoberück, Sebastian and Fendler, Wolfgang P. and Civan, Caner and Bundschuh, Ralph A. and Thomas, Christian and Bjartell, Anders and Trägårdh, Elin and Soeterik, Timo F.W. and Evangelista, Laura and Vondrak, Andrej and Rasul, Sazan and Forner, Laura and Giorgio, Andrea Di and Scholtissek, Helen and Miksch, Jonathan and Holzgreve, Adrien and Lanfranchi, Francesco and Rahbar, Kambiz and Hofman, Michael S. and Rauscher, Isabel and Güven, Osman and Eiber, Matthias and Ayati, Narjess and Umutlu, Lale and Herrmann, Ken and Hadaschik, Boris and Emmett, Louise}},
  issn         = {{0302-2838}},
  keywords     = {{Overall survival; Positron emission tomography; PRIMARY score; Prostate cancer; Prostate-specific membrane antigen}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{123--127}},
  publisher    = {{Elsevier}},
  series       = {{European Urology}},
  title        = {{Association Between the PRIMARY Score at Staging Prostate-specific Membrane Antigen Positron Emission Tomography and Overall Survival Among Patients with Newly Diagnosed Prostate Cancer : Findings from the International, Multicenter PROMISE Registry}},
  url          = {{http://dx.doi.org/10.1016/j.eururo.2025.10.013}},
  doi          = {{10.1016/j.eururo.2025.10.013}},
  volume       = {{89}},
  year         = {{2026}},
}